CAPITAL REGION -- If you want to avoid exposure to the seasonal flu, head to Hamilton County.
The state's smallest by population, the backwoodsy county in the south-central Adirondacks reported no diagnosed flu cases in the week ending Jan. 11 -- and was the only county in the state with no reported cases of the bug.
Other than there, flu is spreading.
The state Health Department reported on Thursday that the total number of flu cases statewide was up 10 percent the previous week, with more than 11,000 cases confirmed. That followed a 9 percent statewide increase the week before. Officially, flu viruses are considered "widespread" across the state.
The vast majority of cases are in New York City, its denser suburbs, and upstate urban areas. But last week alone, six Capital Region counties saw 221 cases; for the season to date, they have seen 768 cases, according to state figures.
"We're seeing more flu cases than last year, for sure," said Ann-Marie Cross, director of emergency services at Saratoga Hospital, which also operates urgent care centers in Wilton and Malta. "I don't know if we've peaked yet, but we're expecting it to continue."
Since October, the state has confirmed nearly 44,000 cases, but that only counts diagnosed cases. Many people -- maybe even some in Hamilton County -- ride out the flu at home, without even getting in touch with a doctor.
The weekly totals for the last two weeks have already exceeded the weekly totals for any week in the 2018-2019 flu season. The 10,000-per-week statewide barrier was broken in the first week of January, about three weeks ahead of when it was broken during the 2017-2018 flu season, which turned out to be the worst in a decade. The state, excluding New York City, has seen three pediatric deaths this season.
The state has been gearing up its response for weeks.
In an advisory issued Jan. 3, the state Health Department said: "The 2019-20 influenza season started earlier than it has in the past three seasons. Influenza activity has not yet peaked, there have been steep increases in cases in the last few weeks, and it is expected to continue to increase in the upcoming weeks."
Gov. Andrew M. Cuomo on Jan. 9 directed the state Health Department to begin enhanced monitoring of hospitals through the Health Emergency Response Data System. That system is intended to ensure hospitals have the capacity, guidance and resources to combat a surge in hospitalizations.
"As the numbers of flu cases and flu hospitalizations continue to rise, I've directed the Department of Health to use every tool at its disposal to make sure our healthcare system remains prepared for an influx of patients," Cuomo said. "While providers are taking extra steps in response to the uptick in the flu season, New Yorkers can still protect themselves and others by getting a flu shot."
Under the emergency response data system, healthcare facilities are required to report flu-related information to the Health Department each week, including their capacity by types of patient care units, whether they have activated their surge plan, and whether they have adequate ventilators and antiviral drugs.
Cross said Saratoga Hospital's emergency and urgent care facilities have added nursing, doctor and physician assistant staffing as part of a surge response plan to deal with the number of cases coming in, and some patients designated for admission have had to be held overnight in the emergency room because the hospital beds are full.
While those coming to the hospital with flu symptoms cover the entire age spectrum, Cross said most of those being admitted are the elderly or those at risk of complications. "The ones that are not so sick they can usually go home with Tamiflu, or whatever," she said.
Both in the state and nationally, this season's illnesses include more of Influenza Type B than in recent years -- Type B is more likely to strike children and young people than most strains of Type A, which has dominated in other years.
On Friday, the federal Centers for Disease Control issued a report that found 32 states, including New York, had "high" flu activity for the week of Jan. 11, a drop of four states from the week before. For what it's worth, Vermont was one of nine states with "low" activity, and New Hampshire was one of five states with "minimal" activity.
In the Capital Region, for the season to date, Albany County has had the most cases in the region: 220. Saratoga has had 202; Schenectady County 139; Montgomery County 66; Fulton County 45; and Schoharie County, 22. Hamilton County since October has reported seven cases, tied for the lowest in the state.
The Capital Region's hospitals put in place flu season visitor protocols starting in early December. Those protocols restrict the number of visitors hospital patients can have, and generally prohibits children from visiting.
The state Health Department said that most people who get sick with flu will have mild illness and will recover in less than two weeks without medical care. Some people, such as older adults, young children, pregnant women, nursing home residents, and people with asthma, lung disease, heart disease, diabetes, or obesity, are more likely to develop flu-related complications.
The department's prevention advice is to get an annual flu shot -- it isn't too late -- stay home while sick, wash hands often, and maintain good health habits.